Tophi as first clinical sign of gout

Abstract

Gout results from deposition of monosodium urate crystals in different body tissues, including the skin and soft tissues. With increasing prosperity a rising prevalence of the disease can be observed, especially in highly industrialized countries. Gout can present with acute and painful attacks of arthritis that can affect several joints. In addition, nodular masses of uric acid crystals can develop, which are referred to as tophi. Although tophaceous gout usually is a sign of long during and chronic disease tophi can also occur as first symptom of the disorder. Here, we report on an 85-year-old woman who was diagnosed with tophaceous gout devoid of a prior medical history of the disease.

Une lésion valvulaire cardiaque inhabituelle

“…• une phase d'hyperuricémie asymptomatique ; • une phase de goutte aiguë, caractérisée par des crises intermittentes ; • une phase de goutte chronique, caractérisée par des dépôts intratissulaires de cristaux d'urate monosodique [1,2].…”

“…Avec la prise en charge précoce de la goutte et depuis l'introduction de l'allopurinol dans son traitement, la découverte de tophus goutteux dans les tissus est devenue rare [1]. La découverte de tophus comme signe révélateur d'une goutte par ailleurs méconnue est un phénomène inhabituel, rapporté dans la littérature très essentiellement au niveau sous-cutané [2].…”

Posttraumatic Tophaceous Gout: A Case Report and Literature Review

“…Despite the idea that tophi represent a more chronic course of gout, they can also present at the initial time of diagnosis despite a lack of joint findings. 1 Tophi also tend to appear more frequently in older people than in younger populations. Risk factors for older patients include the use of low-dose aspirin, alcohol abuse, decreased renal function, and prolonged use of diuretics.…”

New Onset of Very Large Tophi in a Patient After Kidney Transplantation

“…1 Although gouty tophi are seen in chronic disease, in a few conditions tophi may be the first sign of the disorder. 2,3 Hyperuricemia is a common complication in organ transplant recipients and frequently is associated with chronic cyclosporine immunosuppressive therapy. 4,5 Kidney transplant recipients are prone to develop post-transplant hyperuricemia.…”